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Hanifah R, Wahid M, Yasmon A. First report of amphotericin B resistant Candida haemulonii isolated from the ICU of a referral hospital in Indonesia. IRANIAN JOURNAL OF MICROBIOLOGY 2024; 16:280-284. [PMID: 38854988 PMCID: PMC11162170 DOI: 10.18502/ijm.v16i2.15363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Background and Objectives Amphotericin B is a broad-spectrum antifungal agent commonly used to treat Candida haemulonii infection. C. haemulonii was isolated from patients reported to be intrinsically resistant to amphotericin B, encoded by the ERG2 and ERG11 genes. However, there have been limited studies concerning amphotericin B-resistant C. haemulonii in Indonesia. The objective of this study is to explore the phenotypic and genotypic characteristics (ERG2 and ERG11) of C. haemulonii isolated from the ICU of a referral hospital in Indonesia. Materials and Methods Identification and susceptibility tests were conducted using VITEK2. Thereafter, DNA was extracted and amplified using conventional PCR followed by DNA sequencing (Sanger method). Results The results of the phenotypic susceptibility test showed that all C. haemulonii were resistant to amphotericin B. ERG2 and ERG11 sequences showed the same amino acid sequence and corresponded to references that are resistant to amphotericin B. Conclusion The resistant properties of C. haemulonii against amphotericin B found in this study require further exploration, including comparing resistant and sensitive C. haemulonii to amphotericin B. In addition, it is necessary to analyze other genes besides ERG2 and ERG11.
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Affiliation(s)
- Rifdah Hanifah
- Department of Microbiology, Master’s Programme in Biomedical Sciences, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Mardiastuti Wahid
- Department of Clinical Microbiology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Andi Yasmon
- Department of Clinical Microbiology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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2
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Ruiz de Alegría-Puig C, Rodríguez-Lozano J, Agüero-Balbin J. Identification and antifungal susceptibility testing of Candida haemulonii complex isolated from clinical samples. Folia Microbiol (Praha) 2024; 69:165-171. [PMID: 38148373 DOI: 10.1007/s12223-023-01122-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 12/09/2023] [Indexed: 12/28/2023]
Abstract
Candida haemulonii complex (Candida haemulonii [I], Candida duobushaemulonii [II], and Candida haemulonii var. vulnera [III]) has become relevant in recent times, not so much because of a high incidence in human clinical sample cultures but because of its remarkable antifungal resistance. The objective of this study was to evaluate several methods for the identification of this uncommon species of Candida. Ten isolates of C. haemulonii were identified by biochemical and proteomic methods, and their antifungal susceptibility testing was performed by both commercial and reference methods. MALDI-TOF MS (Vitek MS and Vitek MS PRIME) and Vitek2 correctly identified these genera but API method did not. There was a good correlation between the commercial methods and the reference methods for the AST. In conclusion Vitek MS, Vitek MS PRIME, and Vitek2 systems, but not API32C, are reliable for identification of C. haemulonii complex. Furthermore, MALDI-TOF MS systems could identify to the subspecies level. Commercial methods for antifungal susceptibility testing are valid for the study of this species and confirm amphotericin B and to azole resistance.
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Affiliation(s)
- Carlos Ruiz de Alegría-Puig
- Microbiology Service, University Hospital Marqués de Valdecilla-IDIVAL-CIBERINFEC, Avda. Valdecilla s/n, CP 39008, Santander, Spain.
| | - Jesús Rodríguez-Lozano
- Microbiology Service, University Hospital Marqués de Valdecilla-IDIVAL-CIBERINFEC, Avda. Valdecilla s/n, CP 39008, Santander, Spain
| | - Jesús Agüero-Balbin
- Microbiology Service, University Hospital Marqués de Valdecilla-IDIVAL-CIBERINFEC, Avda. Valdecilla s/n, CP 39008, Santander, Spain
- Department of Molecular Biology, University of Cantabria, Santander, Spain
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3
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Angiolella L, Rojas F, Giammarino A, Bellucci N, Giusiano G. Identification of Virulence Factors in Isolates of Candida haemulonii, Candida albicans and Clavispora lusitaniae with Low Susceptibility and Resistance to Fluconazole and Amphotericin B. Microorganisms 2024; 12:212. [PMID: 38276197 PMCID: PMC10819056 DOI: 10.3390/microorganisms12010212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
Emerging life-threatening multidrug-resistant (MDR) species such as the C. haemulonii species complex, Clavispora lusitaniae (sin. C. lusitaniae), and other Candida species are considered as an increasing risk for human health in the near future. (1) Background: Many studies have emphasized that the increase in drug resistance can be associated with several virulence factors in Candida and its knowledge is also essential in developing new antifungal strategies. (2) Methods: Hydrophobicity, adherence, biofilm formation, lipase activity, resistance to osmotic stress, and virulence 'in vivo' on G. mellonella larvae were studied in isolates of C. haemulonii, C. albicans, and C. lusitaniae with low susceptibility and resistance to fluconazole and amphotericin B. (3) Results: Intra- and interspecies variability were observed. C. haemulonii showed high hydrophobicity and the ability to adhere to and form biofilm. C. lusitaniae was less hydrophobic, was biofilm-formation-strain-dependent, and did not show lipase activity. Larvae inoculated with C. albicans isolates displayed significantly higher mortality rates than those infected with C. haemulonii and C. lusitaniae. (4) Conclusions: The ability to adhere to and form biofilms associated with their hydrophobic capacity, to adapt to stress, and to infect within an in vivo model, observed in these non-wild-type Candida and Clavispora isolates, shows their marked virulence features. Since factors that define virulence are related to the development of the resistance of these fungi to the few antifungals available for clinical use, differences in the physiology of these cells must be considered to develop new antifungal therapies.
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Affiliation(s)
- Letizia Angiolella
- Department of Public Health and Infectious Diseases “Sapienza”, University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy; (A.G.); (N.B.)
| | - Florencia Rojas
- Departamento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, CONICET, Resistencia 3500, Argentina; (F.R.); (G.G.)
| | - Andrea Giammarino
- Department of Public Health and Infectious Diseases “Sapienza”, University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy; (A.G.); (N.B.)
| | - Nicolò Bellucci
- Department of Public Health and Infectious Diseases “Sapienza”, University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy; (A.G.); (N.B.)
| | - Gustavo Giusiano
- Departamento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, CONICET, Resistencia 3500, Argentina; (F.R.); (G.G.)
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4
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Francisco EC, de Jong AW, Colombo AL. Candida haemulonii Species Complex: A Mini-review. Mycopathologia 2023; 188:909-917. [PMID: 37391535 DOI: 10.1007/s11046-023-00748-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/12/2023] [Indexed: 07/02/2023]
Abstract
Candida haemulonii species complex (CHSC) are emerging multidrug-resistant yeast pathogens able to cause life-threatening human infections in at-risk populations for invasive candidiasis worldwide. A recent laboratory survey conducted in 12 medical centers found that prevalence rates of Candida haemulonii complex isolates rose from 0.9 to 1.7% along the period between 2008 and 2019. We present a mini-review addressing recent aspects of the epidemiology, diagnosis and therapy of infections due to CHSC.
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Affiliation(s)
- Elaine Cristina Francisco
- Division of Infectious Diseases, Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, 04039-032, Brazil
- Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT, Utrecht, The Netherlands
| | - Auke Wiebren de Jong
- Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT, Utrecht, The Netherlands
- Institute for Biodiversity and Ecosystem Dynamics (IBED), University of Amsterdam, Amsterdam, The Netherlands
| | - Arnaldo Lopes Colombo
- Division of Infectious Diseases, Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, 04039-032, Brazil.
- Division of Infectious Diseases, Universidade Federal de São Paulo, Escola Paulista de Medicina, Rua Pedro de Toledo, 669 5° Andar, São Paulo, CEP, 04039-032, Brazil.
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5
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Du H, Bing J, Xu X, Zheng Q, Hu T, Hao Y, Li S, Nobile CJ, Zhan P, Huang G. Candida vulturna Outbreak Caused by Cluster of Multidrug-Resistant Strains, China. Emerg Infect Dis 2023; 29:1425-1428. [PMID: 37347816 PMCID: PMC10310381 DOI: 10.3201/eid2907.230254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
Candida vulturna belongs to the Candida haemulonii species complex and is phylogenetically related to C. auris. We report a C. vulturna outbreak among persons in Shanxi Province, China, during 2019-2022. Isolates were resistant to multiple antifungal drugs and exhibited enhanced adhesion and biofilm formation properties.
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de Barros Rodrigues DK, Lockhart SR, Berkow EL, Gade L, Bonfietti LX, Mazo Fávero Gimenes V, Silva Ruiz L, Bronze Macioni M, de Souza Carvalho Melhem M. Whole-genome sequencing of Candida haemulonii species complex from Brazil and the United States: Genetic diversity and antifungal susceptibility. Med Mycol 2023; 61:myad030. [PMID: 36931889 PMCID: PMC11321273 DOI: 10.1093/mmy/myad030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 03/06/2023] [Accepted: 03/15/2023] [Indexed: 03/19/2023] Open
Abstract
Candida haemulonii complex species can be multidrug-resistant and cause infections such as candidemia. This study determined the genetic relationship between isolates from Brazil and the United States through whole-genome sequencing and performed antifungal susceptibility testing to investigate drug resistance. Contrary to what is widely described, most isolates were susceptible to azoles. However, an atypical susceptibility profile was found in 50% of Candida pseudohaemulonii strains, including resistance to the three echinocandins. Isolates from both countries formed distinct clusters with wide genetic diversity. Isolates from three hospitals in Brazil were clonal and involved in candidemia cases, pointing to the importance of improving hospital infection control measures and molecular identification.
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Affiliation(s)
| | - Shawn R Lockhart
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Elizabeth L Berkow
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lalitha Gade
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lucas Xavier Bonfietti
- Núcleo de Micologia do Instituto Adolfo Lutz, Secretaria de Saúde, São Paulo, SP, Brazil
| | - Viviane Mazo Fávero Gimenes
- Laboratório de Micologia Médica-LIM 53, Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Luciana Silva Ruiz
- Núcleo de Ciências Biomédicas, Instituto Adolfo Lutz, Regional Bauru, São Paulo, SP, Brazil
| | - Milena Bronze Macioni
- Núcleo de Micologia do Instituto Adolfo Lutz, Secretaria de Saúde, São Paulo, SP, Brazil
- Universidade Paulista, São Paulo, SP, Brazil
| | - Marcia de Souza Carvalho Melhem
- Programa de Pós-graduação em Doenças Infecciosas e Parasitárias, Universidade Federal do Mato Grosso do Sul, Mato Grosso do Sul, MS, Brazil
- Núcleo de Micologia do Instituto Adolfo Lutz, Secretaria de Saúde, São Paulo, SP, Brazil
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7
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Chen X, Jia X, Bing J, Zhang H, Hong N, Liu Y, Xi H, Wang W, Liu Z, Zhang Q, Li L, Kang M, Xiao Y, Yang B, Lin Y, Xu H, Fan X, Huang J, Gong J, Xu J, Xie X, Yang W, Zhang G, Zhang J, Kang W, Wang H, Hou X, Xiao M, Xu Y. Clonal Dissemination of Antifungal-Resistant Candida haemulonii, China. Emerg Infect Dis 2023; 29:576-584. [PMID: 36823029 PMCID: PMC9973686 DOI: 10.3201/eid2903.221082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Candida haemulonii, a relative of C. auris, frequently shows antifungal resistance and is transmissible. However, molecular tools for genotyping and investigating outbreaks are not yet established. We performed genome-based population analysis on 94 C. haemulonii strains, including 58 isolates from China and 36 other published strains. Phylogenetic analysis revealed that C. haemulonii can be divided into 4 clades. Clade 1 comprised strains from China and other global strains; clades 2-4 contained only isolates from China, were more recently evolved, and showed higher antifungal resistance. Four regional epidemic clusters (A, B, C, and D) were identified in China, each comprising ≥5 cases (largest intracluster pairwise single-nucleotide polymorphism differences <50 bp). Cluster A was identified in 2 hospitals located in the same city, suggesting potential intracity transmissions. Cluster D was resistant to 3 classes of antifungals. The emergence of more resistant phylogenetic clades and regional dissemination of antifungal-resistant C. haemulonii warrants further monitoring.
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8
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Cao C, Bing J, Liao G, Nobile CJ, Huang G. Candida haemulonii species complex: emerging fungal pathogens of the Metschnikowiaceae clade. ZOONOSES (BURLINGTON, MASS.) 2023; 3:43. [PMID: 39238892 PMCID: PMC11376483 DOI: 10.15212/zoonoses-2023-0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/07/2024]
Abstract
Candida species represent the most common fungal pathogens of humans, causing not only superficial infections but also life-threatening invasive infections, especially in immunocompromised individuals. While Candida albicans remains the most frequent cause of candidiasis, infections caused by non-albicans Candida species have been increasingly reported in clinical settings over the past two decades. Recently, species of the Metschnikowiaceae clade including the "superbug" Candida auris and other members of the Candida haemulonii species complex have attracted significant attention due to their multidrug resistance and high rates of transmission in clinical settings. In this review, we summarize the epidemiology, biology, virulence, and drug resistance of the C. haemulonii species complex and discuss potential reasons for the recent increase in prevalence of infections caused by non-albicans species in clinical settings.
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Affiliation(s)
- Chengjun Cao
- The Medical Research Institute, College of Pharmaceutical Sciences, Southwest University, Chongqing, 400715, China
- Shanghai Institute of Infectious Disease and Biosecurity, Department of Infectious Diseases, Huashan Hospital and State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, 200438, China
| | - Jian Bing
- Shanghai Institute of Infectious Disease and Biosecurity, Department of Infectious Diseases, Huashan Hospital and State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, 200438, China
| | - Guojian Liao
- The Medical Research Institute, College of Pharmaceutical Sciences, Southwest University, Chongqing, 400715, China
| | - Clarissa J Nobile
- Department of Molecular and Cell Biology, University of California, Merced, CA 95343, USA
- Health Sciences Research Institute, University of California, Merced, CA 95343, USA
| | - Guanghua Huang
- The Medical Research Institute, College of Pharmaceutical Sciences, Southwest University, Chongqing, 400715, China
- Shanghai Institute of Infectious Disease and Biosecurity, Department of Infectious Diseases, Huashan Hospital and State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, 200438, China
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9
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Gómez-Gaviria M, Martínez-Álvarez JA, Chávez-Santiago JO, Mora-Montes HM. Candida haemulonii Complex and Candida auris: Biology, Virulence Factors, Immune Response, and Multidrug Resistance. Infect Drug Resist 2023; 16:1455-1470. [PMID: 36942024 PMCID: PMC10024503 DOI: 10.2147/idr.s402754] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/06/2023] [Indexed: 03/16/2023] Open
Abstract
There is worldwide concern about the constant increase in infections caused by Candida species that are multiresistant to antifungal drugs. The most common candidiasis is caused by Candida albicans, however, the species of the Candida haemulonii complex and Candida auris are emerging opportunistic pathogens, which isolation from clinical samples has significantly increased in the past years. The special interest in the study of these species lies in their ability to evade the action of antifungal drugs, such as amphotericin B, azoles, and echinocandins. In addition, the phenotypic changes of these species have given them the ability to easily adapt to environmental changes, including the host milieu and immunity. In this paper, a detailed review of the current literature on the C. haemulonii complex and C. auris is shown, analyzing aspects such as biology, immune response, putative virulence factors, infection, treatment, and the current strategies for diagnosis.
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Affiliation(s)
- Manuela Gómez-Gaviria
- Departamento de Biología, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, Guanajuato, Gto, México
- Correspondence: Manuela Gómez-Gaviria; Héctor M Mora-Montes, Departamento de Biología, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, Noria Alta s/n, Col. Noria Alta, Guanajuato, Gto, C. P. 36050, México, Tel +52 473-7320006 Ext. 8193, Fax +52 473-7320006 Ext. 8153, Email ;
| | - José A Martínez-Álvarez
- Departamento de Biología, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, Guanajuato, Gto, México
| | - Joaquín O Chávez-Santiago
- Departamento de Biología, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, Guanajuato, Gto, México
| | - Héctor M Mora-Montes
- Departamento de Biología, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, Guanajuato, Gto, México
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10
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Chen XF, Zhang H, Jia XM, Cao J, Li L, Hu XL, Li N, Xiao YL, Xia F, Ye LY, Hu QF, Wu XL, Ning LP, Hsueh PR, Fan X, Yu SY, Huang JJ, Xie XL, Yang WH, Li YX, Zhang G, Zhang JJ, Duan SM, Kang W, Wang T, Li J, Xiao M, Hou X, Xu YC. Antifungal susceptibility profiles and drug resistance mechanisms of clinical Candida duobushaemulonii isolates from China. Front Microbiol 2022; 13:1001845. [PMID: 36545202 PMCID: PMC9760970 DOI: 10.3389/fmicb.2022.1001845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 08/22/2022] [Indexed: 12/12/2022] Open
Abstract
Candida duobushaemulonii, type II Candida haemulonii complex, is closely related to Candida auris and capable of causing invasive and non-invasive infections in humans. Eleven strains of C. duobushaemulonii were collected from China Hospital Invasive Fungal Surveillance Net (CHIF-NET) and identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF), VITEK 2 Yeast Identification Card (YST), and internal transcribed spacer (ITS) sequencing. Whole genome sequencing of C. duobushaemulonii was done to determine their genotypes. Furthermore, C. duobushaemulonii strains were tested by Sensititre YeastOne™ and Clinical and Laboratory Institute (CLSI) broth microdilution panel for antifungal susceptibility. Three C. duobushaemulonii could not be identified by VITEK 2. All 11 isolates had high minimum inhibitory concentrations (MICs) to amphotericin B more than 2 μg/ml. One isolate showed a high MIC value of ≥64 μg/ml to 5-flucytosine. All isolates were wild type (WT) for triazoles and echinocandins. FUR1 variation may result in C. duobushaemulonii with high MIC to 5-flucytosine. Candida duobushaemulonii mainly infects patients with weakened immunity, and the amphotericin B resistance of these isolates might represent a challenge to clinical treatment.
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Affiliation(s)
- Xin-Fei Chen
- 1Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China,2Graduate School, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China,3Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China
| | - Han Zhang
- 1Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China,3Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China
| | - Xin-Miao Jia
- 3Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China,4Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Jin Cao
- 5Jinling Hospital Institute of Clinical Laboratory Science, School of Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Li Li
- 6Department of Dermatology, Hua Shan Hospital, Fudan University, Shanghai, China
| | - Xin-Lan Hu
- 7Department of Laboratory Medicine, Fujian Provincial Hospital, Fuzhou, China
| | - Ning Li
- 7Department of Laboratory Medicine, Fujian Provincial Hospital, Fuzhou, China
| | - Yu-Ling Xiao
- 8Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Fei Xia
- 9Department of Laboratory Medicine, Ruian People's Hospital, Wenzhou, China
| | - Li-Yan Ye
- 10Department of Laboratory Medicine, The First Medicine Center, Chinese PLA General Hospital, Beijing, China
| | - Qing-Feng Hu
- 11Department of Laboratory Medicine, Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Xiao-Li Wu
- 12Department of Laboratory Medicine, The People’s Hospital of Liaoning Province, Shenyang, China
| | - Li-Ping Ning
- 13Department of Laboratory Medicine, No.908 Hospital of Joint Logistics Support Force, Nanchang, China
| | - Po-Ren Hsueh
- 14Department of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan,15Department of Laboratory Medicine and Internal Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Xin Fan
- 16Department of Infectious Diseases and Clinical Microbiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Shu-Ying Yu
- 1Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China,3Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China
| | - Jing-Jing Huang
- 1Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China,2Graduate School, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China,3Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China
| | - Xiu-Li Xie
- 1Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China,3Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China
| | - Wen-Hang Yang
- 1Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China,2Graduate School, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China,3Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China
| | - Ying-Xing Li
- 3Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China,4Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Ge Zhang
- 1Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China,3Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China
| | - Jing-Jia Zhang
- 1Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China,3Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China
| | - Si-Meng Duan
- 1Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China,3Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China
| | - Wei Kang
- 1Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China,3Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China
| | - Tong Wang
- 1Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China,3Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China
| | - Jin Li
- 1Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China,3Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China
| | - Meng Xiao
- 1Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China,3Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China
| | - Xin Hou
- 17Department of Laboratory Medicine, Peking University Third Hospital, Beijing, China,Xin Hou,
| | - Ying-Chun Xu
- 1Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China,3Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China,*Correspondence: Ying-Chun Xu,
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11
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Bilal H, Shafiq M, Hou B, Islam R, Khan MN, Khan RU, Zeng Y. Distribution and antifungal susceptibility pattern of Candida species from mainland China: A systematic analysis. Virulence 2022; 13:1573-1589. [PMID: 36120738 PMCID: PMC9487756 DOI: 10.1080/21505594.2022.2123325] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 08/07/2022] [Accepted: 09/07/2022] [Indexed: 02/05/2023] Open
Abstract
Antifungal resistance to Candida pathogens increases morbidity and mortality of immunosuppressive patients, an emerging crisis worldwide. Understanding the Candida prevalence and antifungal susceptibility pattern is necessary to control and treat candidiasis. We aimed to systematically analyse the susceptibility profiles of Candida species published in the last ten years (December 2011 to December 2021) from mainland China. The studies were collected from PubMed, Google Scholar, and Science Direct search engines. Out of 89 included studies, a total of 44,716 Candida isolates were collected, mainly comprising C. albicans (49.36%), C. tropicalis (21.89%), C. parapsilosis (13.92%), and C. glabrata (11.37%). The lowest susceptibility was detected for azole group; fluconazole susceptibilities against C. parapsilosis, C. albicans, C. glabrata, C. tropicalis, C. guilliermondii, C. pelliculosa, and C. auris were 93.25%, 91.6%, 79.4%, 77.95%, 76%, 50%, and 0% respectively. Amphotericin B and anidulafungin were the most susceptible drugs for all Candida species. Resistance to azole was mainly linked with mutations in ERG11, ERG3, ERG4, MRR1-2, MSH-2, and PDR-1 genes. Mutation in FKS-1 and FKS-2 in C. auris and C. glabrata causing resistance to echinocandins was stated in two studies. Gaps in the studies' characteristics were detected, such as 79.77%, 47.19 %, 26.97%, 7.86%, and 4.49% studies did not mention the mortality rates, age, gender, breakpoint reference guidelines, and fungal identification method, respectively. The current study demonstrates the overall antifungal susceptibility pattern of Candida species, gaps in surveillance studies and risk-reduction strategies that could be supportive in candidiasis therapy and for the researchers in their future studies.
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Affiliation(s)
- Hazrat Bilal
- Department of Dermatology, The second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Muhammad Shafiq
- Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, China
| | - Bing Hou
- Department of laboratory, Shantou Municipal Skin Hospital, Shantou, China
| | - Rehmat Islam
- Key Laboratory of Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi’an, China
| | - Muhammad Nadeem Khan
- Faculty of Biological Sciences, Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Rahat Ullah Khan
- Institute of Microbiology, Faculty of Veterinary and Animal Sciences Gomal University, Dera Ismail Khan, Pakistan
| | - Yuebin Zeng
- Department of Dermatology, The second Affiliated Hospital of Shantou University Medical College, Shantou, China
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Chen XF, Hou X, Zhang H, Jia XM, Ning LP, Cao W, Fan X, Huang JJ, Yang WH, Zhang G, Zhang JJ, Kang W, Xiao M, Xu YC. First two fungemia cases caused by Candida haemulonii var. vulnera in China with emerged antifungal resistance. Front Microbiol 2022; 13:1036351. [PMID: 36466633 PMCID: PMC9710277 DOI: 10.3389/fmicb.2022.1036351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 10/17/2022] [Indexed: 11/11/2022] Open
Abstract
Candida haemulonii var. vulnera is a rare variant of C. haemulonii, which has been previously reported to cause human infections. Owing to the close kinship between C. haemulonii sensu stricto and C. haemulonii var. vulnera, accurate identification of C. haemulonii var. vulnera relied on DNA sequencing assay targeting, for example, rDNA internal transcribed spacer (ITS) region. In this work, two strains of C. haemulonii var. vulnera were collected from the China Hospital Invasive Fungal Surveillance Net (CHIF-NET). The identification capacity of three matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and VITEK 2 YST ID biochemical methods were evaluated against ITS sequencing. In addition, antifungal susceptibility testing was performed using Sensititre YeastOne. Moreover, we comprehensively screened drug-resistant related genes by whole-genome sequencing. The two strains were not correctly identified to species variant level using MALDI-TOF MS and YST ID cards. Both strains were resistant to amphotericin B (minimum inhibitory concentration [MIC] > 2 μg/ml). Moreover, strain F4564 and F4584 exhibited high MIC to fluconazole (>256 μg/ml) and 5-flucytosine (>64 μg/ml), respectively, which were supposed to result from key amino acid substitutions Y132F and G307A in Erg11p and V58fs and G60K substitutions in Fur1p. The rare species C. haemulonii var. vulnera has emerged in China, and such drug-resistant fungal species that can cause invasive diseases require further close attention.
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Affiliation(s)
- Xin-Fei Chen
- Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,Graduate School, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases (BZ0447), Beijing, China
| | - Xin Hou
- Department of Laboratory Medicine, Peking University Third Hospital, Beijing, China
| | - Han Zhang
- Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases (BZ0447), Beijing, China
| | - Xin-Miao Jia
- Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases (BZ0447), Beijing, China,Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li-Ping Ning
- Department of Laboratory Medicine, No.908 Hospital of Joint Logistics Support Force, Nanchang, Jiangxi, China
| | - Wei Cao
- Department of Laboratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hubei, China
| | - Xin Fan
- Department of Infectious Diseases and Clinical Microbiology, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Jing-Jing Huang
- Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,Graduate School, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases (BZ0447), Beijing, China
| | - Wen-Hang Yang
- Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases (BZ0447), Beijing, China
| | - Ge Zhang
- Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases (BZ0447), Beijing, China
| | - Jing-Jia Zhang
- Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases (BZ0447), Beijing, China
| | - Wei Kang
- Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases (BZ0447), Beijing, China
| | - Meng Xiao
- Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases (BZ0447), Beijing, China,*Correspondence: Meng Xiao,
| | - Ying-Chun Xu
- Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases (BZ0447), Beijing, China,Ying-Chun Xu,
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Nationwide Surveillance of Antifungal Resistance of Candida Bloodstream Isolates in South Korean Hospitals: Two Year Report from Kor-GLASS. J Fungi (Basel) 2022; 8:jof8100996. [PMID: 36294562 PMCID: PMC9604804 DOI: 10.3390/jof8100996] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 11/17/2022] Open
Abstract
We incorporated nationwide Candida antifungal surveillance into the Korea Global Antimicrobial Resistance Surveillance System (Kor-GLASS) for bacterial pathogens. We prospectively collected and analyzed complete non-duplicate blood isolates and information from nine sentinel hospitals during 2020−2021, based on GLASS early implementation protocol for the inclusion of Candida species. Candida species ranked fourth among 10,758 target blood pathogens and second among 4050 hospital-origin blood pathogens. Among 766 Candida blood isolates, 87.6% were of hospital origin, and 41.3% occurred in intensive care unit patients. Adults > 60 years of age accounted for 75.7% of cases. Based on species-specific clinical breakpoints, non-susceptibility to fluconazole, voriconazole, caspofungin, micafungin, and anidulafungin was found in 21.1% (154/729), 4.0% (24/596), 0.1% (1/741), 0.0% (0/741), and 0.1% (1/741) of the isolates, respectively. Fluconazole resistance was determined in 0% (0/348), 2.2% (3/135, 1 Erg11 mutant), 5.3% (7/133, 6 Pdr1 mutants), and 5.6% (6/108, 4 Erg11 and 1 Cdr1 mutants) of C. albicans, C. tropicalis, C. glabrata, and C. parapsilosis isolates, respectively. An echinocandin-resistant C. glabrata isolate harbored an F659Y mutation in Fks2p. The inclusion of Candida species in the Kor-GLASS system generated well-curated surveillance data and may encourage global Candida surveillance efforts using a harmonized GLASS system.
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The Threat Called Candida haemulonii Species Complex in Rio de Janeiro State, Brazil: Focus on Antifungal Resistance and Virulence Attributes. J Fungi (Basel) 2022; 8:jof8060574. [PMID: 35736057 PMCID: PMC9225368 DOI: 10.3390/jof8060574] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/24/2022] [Accepted: 05/24/2022] [Indexed: 02/01/2023] Open
Abstract
Although considered rare, the emergent Candida haemulonii species complex, formed by C. haemulonii sensu stricto (Ch), C. duobushaemulonii (Cd) and C. haemulonii var. vulnera (Chv), is highlighted due to its profile of increased resistance to the available antifungal drugs. In the present work, 25 clinical isolates, recovered from human infections during 2011–2020 and biochemically identified by automated system as C. haemulonii, were initially assessed by molecular methods (amplification and sequencing of ITS1-5.8S-ITS2 gene) for precise species identification. Subsequently, the antifungal susceptibility of planktonic cells, biofilm formation and susceptibility of biofilms to antifungal drugs and the secretion of key molecules, such as hydrolytic enzymes, hemolysins and siderophores, were evaluated by classical methodologies. Our results revealed that 7 (28%) isolates were molecularly identified as Ch, 7 (28%) as Chv and 11 (44%) as Cd. Sixteen (64%) fungal isolates were recovered from blood. Regarding the antifungal susceptibility test, the planktonic cells were resistant to (i) fluconazole (100% of Ch and Chv, and 72.7% of Cd isolates), itraconazole and voriconazole (85.7% of Ch and Chv, and 72.7% of Cd isolates); (ii) no breakpoints were defined for posaconazole, but high MICs were observed for 85.7% of Ch and Chv, and 72.7% of Cd isolates; (iii) all isolates were resistant to amphotericin B; and (iv) all isolates were susceptible to echinocandins (except for one isolate of Cd) and to flucytosine (except for two isolates of Cd). Biofilm is a well-known virulence and resistant structure in Candida species, including the C. haemulonii complex. Herein, we showed that all isolates were able to form viable biofilms over a polystyrene surface. Moreover, the mature biofilms formed by the C. haemulonii species complex presented a higher antifungal-resistant profile than their planktonic counterparts. Secreted molecules associated with virulence were also detected in our fungal collection: 100% of the isolates yielded aspartic proteases, hemolysins and siderophores as well as phospholipase (92%), esterase (80%), phytase (80%), and caseinase (76%) activities. Our results reinforce the multidrug resistance profile of the C. haemulonii species complex, including Brazilian clinical isolates, as well as their ability to produce important virulence attributes such as biofilms and different classes of hydrolytic enzymes, hemolysins and siderophores, which typically present a strain-dependent profile.
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Muthusamy A, Rao M, Chakrabarti A, Velayuthan R. Case report: Catheter related blood stream infection caused by Candida vulturna. Med Mycol Case Rep 2022; 36:27-30. [PMID: 35495370 PMCID: PMC9043870 DOI: 10.1016/j.mmcr.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/03/2022] [Accepted: 04/09/2022] [Indexed: 11/26/2022] Open
Abstract
Candida vulturna is a newly emerging candida species belong to Candida haemulonii species complex of Metschnikowiaceae family. Numerous clinical samples have been reported to isolate C. vulturna since discovery. We report a case of catheter related blood stream infection in which C. vulturna was isolated from blood in patient after prolong antibiotic therapy for recurrent infection of retroperitoneal cyst. The blood isolate was identified to species level by molecular assay targeting D1/D2 regions of 26s rDNA gene. The patient improved with administration of intravenous micafungin despite lack of antifungal susceptibility breakpoints.
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Phenotypic Switching and Filamentation in Candida haemulonii, an Emerging Opportunistic Pathogen of Humans. Microbiol Spectr 2021; 9:e0077921. [PMID: 34878301 PMCID: PMC8653834 DOI: 10.1128/spectrum.00779-21] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Phenotypic plasticity is a common strategy adopted by fungal pathogens to adapt to diverse host environments. Candida haemulonii is an emerging multidrug-resistant human pathogen that is closely related to Candida auris. Until recently, it was assumed that C. haemulonii is incapable of phenotypic switching or filamentous growth. In this study, we report the identification of three distinct phenotypes in C. haemulonii: white, pink, and filament. The white and pink phenotypes differ in cellular size, colony morphology, and coloration on phloxine B- or CuSO4-containing agar. Switching between the white and pink cell types is heritable and reversible and is referred to as “the primary switching system.” The additional switch phenotype, filament, has been identified and exhibits obviously filamentous morphology when grown on glycerol-containing medium. Several unique characteristics of the filamentous phenotype suggest that switching from or to this phenotype poses as a second yeast-filament switching system. The yeast-filament switch is nonheritable and temperature-dependent. Low temperatures favor the filamentous phenotype, whereas high temperatures promote filament-yeast transition. We further demonstrated that numerous aspects of the distinct cell types differ in numerous biological aspects, including their high temperature response, specific gene expression, CuSO4 tolerance, secreted aspartyl protease (SAP) activity, and virulence. Therefore, transition among the three phenotypes could enable C. haemulonii to rapidly adapt to, survive, and thrive in certain host niches, thereby contributing to its virulence. IMPORTANCE The capacity to switch between distinct cell types, known as phenotypic switching, is a common strategy adopted by Candida species to adapt to diverse environments. Despite considerable studies on phenotypic plasticity of various Candida species, Candida haemulonii is considered to be incapable of phenotypic switching or filamentous growth. Here, we report and describe filamentation and three distinct phenotypes (white, pink, and filament) in C. haemulonii. The three cell types differ in cellular and colony appearance, gene expression profiles, CuSO4 tolerance, and virulence. C. haemulonii cells switch heritably and reversibly between white and pink cell types, which is referred to as the “primary switching system.” Switching between pink and filamentous phenotypes is nonheritable and temperature-dependent, representing a second switching system. As in other Candida species, switching among distinct morphological types may provide C. haemulonii with phenotypic plasticity for rapid responses to the changing host environment, and may contribute to its virulence.
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Awada B, Alam W, Chalfoun M, Araj G, Bizri AR. COVID-19 and Candida duobushaemulonii superinfection: A case report. J Mycol Med 2021; 31:101168. [PMID: 34186378 PMCID: PMC8206624 DOI: 10.1016/j.mycmed.2021.101168] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/11/2021] [Accepted: 06/11/2021] [Indexed: 12/27/2022]
Abstract
Introduction Critically ill COVID-19 patients are at high risk for nosocomial bacterial and fungal infections due to several predisposing factors such as intensive care unit stay, mechanical ventilation, and broad-spectrum antibiotics. Data regarding multidrug resistant (MDR) Candida species in COVID-19 patients is scarce, and nonexistent regarding Candida duobushaemulonii superinfections. Case description A 34-year-old male presented to our institution with acute respiratory distress syndrome (ARDS) due to COVID-19 infection and developed Candida duobushaemulonii fungemia after multiple courses of antibiotics and prolonged mechanical ventilation. He died after recurrent pneumothorax led to respiratory failure and cardiac arrest. Discussion Bacterial and fungal infections are common complications of viral pneumonia in critically ill patients. Data regarding these infections in COVID-19 patients has been poorly studied with only a few cases reporting secondary infection, mostly without identifying specific pathogens. Prolonged hospital stays, invasive interventions (central venous catheter, mechanical ventilation), and the use of broad-spectrum antibiotics in COVID-19 infections could carry a high risk of bacterial and/or fungal superinfections. Conclusion Strategies to improve outcome in COVID-19 ICU patients should include early recognition of candidemia and appropriate antifungal therapy.
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Affiliation(s)
- Bassem Awada
- Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon
| | - Walid Alam
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
| | - Maria Chalfoun
- Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - George Araj
- Department of Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Abdul Rahman Bizri
- Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon
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Kidd SE, Crawford LC, Halliday CL. Antifungal Susceptibility Testing and Identification. Infect Dis Clin North Am 2021; 35:313-339. [PMID: 34016280 DOI: 10.1016/j.idc.2021.03.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The requirement for antifungal susceptibility testing is increasing given the availability of new drugs, increasing populations of individuals at risk for fungal infection, and emerging multiresistant fungi. Rapid and accurate fungal identification remains at the forefront of laboratory efforts to guide empiric therapy. Antifungal susceptibility testing methods have greatly improved, but are subject to variation in results between methods. Careful standardization, validation, and extensive training of users is essential to ensure susceptibility results are clinically useful and interpreted appropriately. Interpretive criteria for many drugs and species are still lacking, but this will continue to evolve.
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Affiliation(s)
- Sarah E Kidd
- National Mycology Reference Centre, Microbiology & Infectious Diseases, SA Pathology, SA Pathology (Frome Campus), PO Box 14, Rundle Mall, Adelaide, South Australia 5000, Australia; School of Biological Sciences, University of Adelaide, Adelaide, South Australia, Australia.
| | - Lucy C Crawford
- Microbiology & Infectious Diseases, SA Pathology, PO Box 14, Rundle Mall, Adelaide, South Australia 5000, Australia; Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Catriona L Halliday
- Clinical Mycology Reference Laboratory, Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, NSW Health Pathology, Westmead Hospital, The University of Sydney, Level 3 ICPMR, Darcy Road, Westmead, New South Wales 2145, Australia
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Van Bang BN, Thanh Xuan N, Xuan Quang D, Ba Loi C, Thai Ngoc Minh N, Nhu Lam N, Ngoc Anh D, Thi Thu Hien T, Xuan Su H, Tran-Anh L. Prevalence, species distribution, and risk factors of fungal colonization and infection in patients at a burn intensive care unit in Vietnam. Curr Med Mycol 2021; 6:42-49. [PMID: 33834142 PMCID: PMC8018815 DOI: 10.18502/cmm.6.3.4664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background and Purpose : Burn patients are at a higher risk of infections caused by different organisms. This study aimed to address the prevalence, causative species, and factors related to fungal colonization or infection in patients with acute severe injuries admitted to the intensive care unit (ICU) of a burn hospital in northern Vietnam. Materials and Methods: This prospective study was conducted on 400 patients in a burn ICU between 2017 and 2019. Clinical samples were weekly collected and screened for fungi, and relevant clinical information was obtained from medical records. Results: According to the results, 90% of the patients were colonized with fungi. Out of this group, 12.75% of the cases had
invasive fungal infection (IFI). Eleven yeasts and six mold species were isolated from the patients, with the most
common species being Candida tropicalis (45.56%) and C. albicans (41.94%). Among the eleven species causing
fungal wound infection (FWI), the most common agents were Candida (66.7% of FWI patients) and Aspergillus (38.5%) species.
Three Candida species isolated from blood were C. tropicalis (66.7%), C. albicans (20.0%),
and C. parapsilosis (14.3%). No factors were found to expose the patients to a higher risk of fungal colonization.
However, hyperglycemia, prolonged ICU stay, and heavy Candida species colonization were found to be independently predictive of IFI. Conclusion: Burn patients are at the risk of fungal infection with Candida species (especially C. tropicalis)
and Aspergillus as the most frequently responsible agents. Continuous surveillance of fungi and appropriate management
of pathophysiological consequences are essential to prevent fungal infection in burn patients.
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Affiliation(s)
- Be Nguyen Van Bang
- Department of Hamatology, Toxicology, Radiation, and Occupational Diseases, Military Hospital 103, Vietnam Military Medical University, Ha Dong, Ha Noi, Vietnam
| | - Nguyen Thanh Xuan
- Department of Medical Education, Military Hospital 103, Vietnam Military Medical University, Ha Dong, Ha Noi, Vietnam
| | - Dinh Xuan Quang
- Department of Scientific and Training Management, National Institute of Malaria, Parasitology, and Entomology, Nam Tu Liem, Ha Noi, Vietnam
| | - Cao Ba Loi
- Department of Scientific and Training Management, National Institute of Malaria, Parasitology, and Entomology, Nam Tu Liem, Ha Noi, Vietnam
| | - Nguyen Thai Ngoc Minh
- Intensive Care Unit, National Hospital of Burn, Vietnam Military Medical University, Ha Dong, Ha Noi, Vietnam
| | - Nguyen Nhu Lam
- Intensive Care Unit, National Hospital of Burn, Vietnam Military Medical University, Ha Dong, Ha Noi, Vietnam
| | - Do Ngoc Anh
- Department of Parasitology, Vietnam Military Medical University, Ha Dong, Ha Noi, Vietnam
| | - Truong Thi Thu Hien
- Department of Microbiology, National Hospital of Burn, Vietnam Military Medical University, Ha Dong, Ha Noi, Vietnam
| | - Hoang Xuan Su
- Department of Microbiology and Pathogens, Institute of Biomedicine and Pharmacy, National Hospital of Burn, Vietnam Military Medical University, Ha Dong, Ha Noi, Vietnam These authors contributed equally to this work and acted as joint first authors
| | - Le Tran-Anh
- Department of Parasitology, Vietnam Military Medical University, Ha Dong, Ha Noi, Vietnam
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Montoya AM, Luna-Rodríguez CE, Bonifaz A, Treviño-Rangel RDJ, Rojas OC, González GM. Physiological characterization and molecular identification of some rare yeast species causing onychomycosis. J Mycol Med 2021; 31:101121. [PMID: 33626414 DOI: 10.1016/j.mycmed.2021.101121] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 02/08/2021] [Accepted: 02/12/2021] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Onychomycosis are infections with a variety of etiological agents. Although dermatophytes are responsible for most infections, yeasts are gaining importance as agents of these pathologies. The use of antifungals has increased the incidence of what had been considered rare or novel pathogens. We reidentify three rare yeasts from a culture collection of onychomycosis agents by matrix-assisted laser desorption/ionization time of flight/mass spectrometry (MALDI-TOF/MS) and sequencing the internal transcribed spacer (ITS) regions or the intergenic spacer (IGS) 1 region of ribosomal DNA (rDNA), and present their enzymatic and antifungal susceptibility profiles. MATERIAL AND METHODS We performed a phenotypical characterization and molecular identification of five yeast isolates. We tested the urease, gelatinase, DNase, phospholipase, protease, and esterase activities, as well as the hemolytic activity. We evaluated the antifungal susceptibility to amphotericin B, fluconazole, anidulafungin and caspofungin. RESULTS Phenotypic methods could not identify the isolates. MALDI-TOF/MS was able to properly identify Candida duobushameulonii. The five isolates were successfully identified by sequence analysis as Candida duobushaemulonii, Meyerozyma caribbica and Cutaneotrichosporon dermatis. Candida duobushameulonii showed hemolytic, phospholipase, and protease activities. Meyerozyma caribbica was positive for gelatinase and protease activities. All antifungals exhibited minimum inhibitory concentrations (MICs) ≤2μg/mL against both species. The three isolates of Cutaneotrichosporon dermatis showed urease, DNase, and esterase activities, and resistance to echinocandins (MICs ≥8μg/mL), while amphotericin B and fluconazole exhibited low MICs against these isolates (0.50-2μg/mL). DISCUSSION Sequencing of the ITS or IGS1 regions of rDNA remains the best method for identifying cryptic species over other commercially available systems. More reports are needed to define the enzymatic and antifungal profiles for these species. This is the first report of Meyerozyma caribbica and Cutaneotrichosporon dermatis as etiological agents of onychomycosis.
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Affiliation(s)
- Alexandra M Montoya
- Departamento de Microbiología, Facultad de Medicina, Universidad Autónoma de Nuevo León, avenue Francisco I. Madero s/n, 64460 Monterrey, México.
| | - Carolina E Luna-Rodríguez
- Departamento de Microbiología, Facultad de Medicina, Universidad Autónoma de Nuevo León, avenue Francisco I. Madero s/n, 64460 Monterrey, México.
| | - Alexandro Bonifaz
- Servicio de Dermatología y Departamento de Microbiología, Hospital General de México "Dr. Eduardo Liceaga", Ciudad de México, México.
| | - Rogelio de J Treviño-Rangel
- Departamento de Microbiología, Facultad de Medicina, Universidad Autónoma de Nuevo León, avenue Francisco I. Madero s/n, 64460 Monterrey, México.
| | - Olga C Rojas
- Departamento de Microbiología, Facultad de Medicina, Universidad Autónoma de Nuevo León, avenue Francisco I. Madero s/n, 64460 Monterrey, México.
| | - Gloria M González
- Departamento de Microbiología, Facultad de Medicina, Universidad Autónoma de Nuevo León, avenue Francisco I. Madero s/n, 64460 Monterrey, México.
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Candida duobushaemulonii: An Old But Unreported Pathogen. J Fungi (Basel) 2020; 6:jof6040374. [PMID: 33348882 PMCID: PMC7766551 DOI: 10.3390/jof6040374] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/15/2020] [Accepted: 12/15/2020] [Indexed: 01/02/2023] Open
Abstract
Candidiasis caused by species of the Candida haemulonii complex (Candida haemulonii and Candida duobushaemulonii) and closely related species, Candida auris and Candida pseudohaemulonii are increasing. These species often show reduced susceptibility to antifungal drugs, such as azoles and amphotericin B or, less frequently, echinocandins. However, conventional phenotypic identification methods are unable to accurately differentiate these species and, therefore, their prevalence may have been underestimated. In this study, 150 isolates that were probably misidentified were reanalyzed using two novel PCR approaches. We found that one isolate previously identified in 1996 as Candida intermedia was C. duobushaemulonii, being one of the oldest isolates of this species described to date. We also found that this isolate had reduced susceptibility to fluconazole, itraconazole, and amphotericin B.
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22
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Carolus H, Pierson S, Lagrou K, Van Dijck P. Amphotericin B and Other Polyenes-Discovery, Clinical Use, Mode of Action and Drug Resistance. J Fungi (Basel) 2020; 6:E321. [PMID: 33261213 PMCID: PMC7724567 DOI: 10.3390/jof6040321] [Citation(s) in RCA: 117] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/25/2020] [Accepted: 11/25/2020] [Indexed: 12/21/2022] Open
Abstract
Although polyenes were the first broad spectrum antifungal drugs on the market, after 70 years they are still the gold standard to treat a variety of fungal infections. Polyenes such as amphotericin B have a controversial image. They are the antifungal drug class with the broadest spectrum, resistance development is still relatively rare and fungicidal properties are extensive. Yet, they come with a significant host toxicity that limits their use. Relatively recently, the mode of action of polyenes has been revised, new mechanisms of drug resistance were discovered and emergent polyene resistant species such as Candida auris entered the picture. This review provides a short description of the history and clinical use of polyenes, and focusses on the ongoing debate concerning their mode of action, the diversity of resistance mechanisms discovered to date and the most recent trends in polyene resistance development.
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Affiliation(s)
- Hans Carolus
- VIB-KU Leuven Center for Microbiology, 3001 Leuven, Belgium; (H.C.); (S.P.)
- Laboratory of Molecular Cell Biology, Department of Biology, KU Leuven, 3001 Leuven, Belgium
| | - Siebe Pierson
- VIB-KU Leuven Center for Microbiology, 3001 Leuven, Belgium; (H.C.); (S.P.)
- Laboratory of Molecular Cell Biology, Department of Biology, KU Leuven, 3001 Leuven, Belgium
| | - Katrien Lagrou
- Laboratory of Clinical Bacteriology and Mycology, Department of Microbiology, Immunology and Transplantation, KU Leuven, 3001 Leuven, Belgium;
- Department of Laboratory Medicine and National Reference Center for Mycosis, UZ Leuven, 3001 Leuven, Belgium
| | - Patrick Van Dijck
- VIB-KU Leuven Center for Microbiology, 3001 Leuven, Belgium; (H.C.); (S.P.)
- Laboratory of Molecular Cell Biology, Department of Biology, KU Leuven, 3001 Leuven, Belgium
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23
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Insights into the Multi-Azole Resistance Profile in Candida haemulonii Species Complex. J Fungi (Basel) 2020; 6:jof6040215. [PMID: 33050545 PMCID: PMC7711680 DOI: 10.3390/jof6040215] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/06/2020] [Accepted: 10/08/2020] [Indexed: 12/25/2022] Open
Abstract
The Candida haemulonii complex (C. duobushaemulonii, C. haemulonii, and C. haemulonii var. vulnera) is composed of emerging, opportunistic human fungal pathogens able to cause invasive infections with high rates of clinical treatment failure. This fungal complex typically demonstrates resistance to first-line antifungals, including fluconazole. In the present work, we have investigated the azole resistance mechanisms expressed in Brazilian clinical isolates forming the C. haemulonii complex. Initially, 12 isolates were subjected to an antifungal susceptibility test, and azole cross-resistance was detected in almost all isolates (91.7%). In order to understand the azole resistance mechanistic basis, the efflux pump activity was assessed by rhodamine-6G. The C. haemulonii complex exhibited a significantly higher rhodamine-6G efflux than the other non-albicans Candida species tested (C. tropicalis, C. krusei, and C. lusitaneae). Notably, the efflux pump inhibitors (Phe-Arg and FK506) reversed the fluconazole and voricolazole resistance phenotypes in the C. haemulonii species complex. Expression analysis indicated that the efflux pump (ChCDR1, ChCDR2, and ChMDR1) and ERG11 genes were not modulated by either fluconazole or voriconazole treatments. Further, ERG11 gene sequencing revealed several mutations, some of which culminated in amino acid polymorphisms, as previously reported in azole-resistant Candida spp. Collectively, these data point out the relevance of drug efflux pumps in mediating azole resistance in the C. haemulonii complex, and mutations in ERG11p may contribute to this resistance profile.
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24
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Susceptibility of the Candida haemulonii Complex to Echinocandins: Focus on Both Planktonic and Biofilm Life Styles and a Literature Review. J Fungi (Basel) 2020; 6:jof6040201. [PMID: 33019733 PMCID: PMC7711677 DOI: 10.3390/jof6040201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/25/2020] [Accepted: 09/30/2020] [Indexed: 02/05/2023] Open
Abstract
Candida haemulonii complex (C. haemulonii, C. duobushaemulonii and C. haemulonii var. vulnera) is well-known for its resistance profile to different available antifungal drugs. Although echinocandins are the most effective class of antifungal compounds against the C. haemulonii species complex, clinical isolates resistant to caspofungin, micafungin and anidulafungin have already been reported. In this work, we present a literature review regarding the effects of echinocandins on this emergent fungal complex. Published data has revealed that micafungin and anidulafungin were more effective than caspofungin against the species forming the C. haemulonii complex. Subsequently, we investigated the susceptibilities of both planktonic and biofilm forms of 12 Brazilian clinical isolates of the C. haemulonii complex towards caspofungin and micafungin (anidulafungin was unavailable). The planktonic cells of all the fungal isolates were susceptible to both of the test echinocandins. Interestingly, echinocandins caused a significant reduction in the biofilm metabolic activity (viability) of almost all fungal isolates (11/12, 91.7%). Generally, the biofilm biomasses were also affected (reduction range 20–60%) upon exposure to caspofungin and micafungin. This is the first report of the anti-biofilm action of echinocandins against the multidrug-resistant opportunistic pathogens comprising the C. haemulonii complex, and unveils the therapeutic potential of these compounds.
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25
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Lima SL, Rossato L, Salles de Azevedo Melo A. Evaluation of the potential virulence of Candida haemulonii species complex and Candida auris isolates in Caenorhabditis elegans as an in vivo model and correlation to their biofilm production capacity. Microb Pathog 2020; 148:104461. [PMID: 32835773 DOI: 10.1016/j.micpath.2020.104461] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/19/2020] [Accepted: 08/17/2020] [Indexed: 12/13/2022]
Abstract
Candida haemulonii species complex (Can. haemulonii sensu stricto, Can. duobushaemulonii and Can. haemulonii var. vulnera) and related species (Can. auris and Can. pseudohaemulonii) have attracted attention due to reduced susceptibility to azoles and amphotericin B. Furthermore, attributes of potential virulence have been recognized in Can. haemulonii species complex and Can. auris, like the capability to form biofilm, which represent the most important risk factors for persistent candidemia. However, the relationship between biofilm production and impact on host mortality is still unclear. To evaluate the potential virulence of Can. haemulonii species complex and Can. auris isolates by correlating biofilm production and capacity to kill Caenorhabditis elegans as an in vivo model. In this study, virulence factors were characterized among a total of sixty-six Can. haemulonii species complex and Can. auris isolates to gain insight about virulence traits of these pathogenic yeasts by evaluating the in vitro biofilm production and potential pathogenicity for Cae. elegans, as an in vivo infection model. All clinical isolates tested were biofilm producer, inter- and intra-specific differences on the biofilm forming capacity by the strains were observed. Can. auris and Can. haemuolonii var. vulnera showed similar biofilm production, both higher than Can. haemulonii sensu stricto and Can. duobushaemulonii. Regarding the virulence of the Cae. elegans model, Can. haemulonii species complex and Can. auris isolates were capable of causing infection in Cae. elegans, and our data suggest that the high biofilm production by Can. haemulonii var. vulnera and Can. duobushaemulonii isolates may impact in the pathogenicity caused on Cae. elegans.
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Affiliation(s)
- Soraia Lopes Lima
- Special Laboratory of Mycology, Federal University of São Paulo, São Paulo, Brazil
| | - Luana Rossato
- Special Laboratory of Mycology, Federal University of São Paulo, São Paulo, Brazil
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26
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Candida haemulonii: An emerging opportunistic pathogen in the United States? IDCases 2020; 21:e00900. [PMID: 32685371 PMCID: PMC7358735 DOI: 10.1016/j.idcr.2020.e00900] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/30/2020] [Accepted: 06/30/2020] [Indexed: 11/24/2022] Open
Abstract
Candida species are ubiquitous fungal pathogens that exhibit increasing resistance to anti-fungal agents. Candida haemulonii, a rare subtype, is an emerging and virulent yeast pathogen. Species identification is difficult due to phenotypic similarity to other Candida subtypes, such that there is a high risk of inappropriate antimicrobial administration and worsening of emerging resistance patterns. Candida haemulonii has a proclivity for infection of chronic lower extremity wounds particularly in diabetic patients, as exemplified in our case. This case raises awareness about the necessity for expeditious identification and antimicrobial stewardship directed to a highly resistant emerging pathogen.
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27
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Increasing Prevalence of Multidrug-Resistant Candida haemulonii Species Complex among All Yeast Cultures Collected by a Reference Laboratory over the Past 11 Years. J Fungi (Basel) 2020; 6:jof6030110. [PMID: 32679832 PMCID: PMC7558365 DOI: 10.3390/jof6030110] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/10/2020] [Accepted: 07/13/2020] [Indexed: 01/02/2023] Open
Abstract
There is worldwide concern with the increasing rates of infections due to multiresistant Candida isolates reported in tertiary medical centers. We checked for historical trends in terms of prevalence rates and antifungal susceptibility of the Candida haemulonii species complex in our yeast stock culture collected during the last 11 years. The isolates were identified by sequencing the rDNA internal transcribed spacer (ITS) region, and antifungal susceptibility tests for amphotericin B, voriconazole, fluconazole, anidulafungin, and 5-fluorocytosine were performed by the Clinical and Laboratory Standards Institute (CLSI) microbroth method. A total of 49 isolates were identified as Candida haemuloniisensu stricto (n = 21), followed by C. haemulonii var. vulnera (n = 15) and C. duobushaemulonii (n = 13), including 38 isolates cultured from patients with deep-seated Candida infections. The prevalence of the C. haemulonii species complex increased from 0.9% (18 isolates among 1931) in the first period (December 2008 to June 2013) to 1.7% (31 isolates among 1868) in the second period (July 2014 to December 2019) of analysis (p = 0.047). All isolates tested exhibited high minimum inhibition concentrations for amphotericin B and fluconazole, but they remained susceptible to 5-fluorocytosine and anidulafungin. We were able to demonstrate the increased isolation of the multiresistant Candida haemulonii species complex in our culture collection, where most isolates were cultured from patients with deep-seated infections.
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28
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Rodrigues LS, Gazara RK, Passarelli-Araujo H, Valengo AE, Pontes PVM, Nunes-da-Fonseca R, de Souza RF, Venancio TM, Dalla-Costa LM. First Genome Sequences of Two Multidrug-Resistant Candida haemulonii var. vulnera Isolates From Pediatric Patients With Candidemia. Front Microbiol 2020; 11:1535. [PMID: 32719671 PMCID: PMC7350289 DOI: 10.3389/fmicb.2020.01535] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 06/12/2020] [Indexed: 12/20/2022] Open
Abstract
Candida haemulonii is a complex formed by C. haemulonii sensu stricto, C. haemulonii var. vulnera, and C. duobushaemulonii. Members of this complex are opportunistic pathogens closely related to C. pseudohaemulonii, C. lusitaniae, and C. auris, all members of a multidrug-resistant clade. Complete genome sequences for all members of this group are available in the GenBank database, except for C. haemulonii var. vulnera. Here, we report the first draft genomes of two C. haemulonii var. vulnera (isolates K1 and K2) and comparative genome analysis of closely related fungal species. The isolates were biofilm producers and non-susceptible to amphotericin B and fluconazole. The draft genomes comprised 350 and 387 contigs and total genome sizes of 13.21 and 13.26 Mb, with 5,479 and 5,507 protein-coding genes, respectively, allowing the identification of virulence and resistance genes. Comparative analyses of orthologous genes within the multidrug-resistant clade showed a total of 4,015 core clusters, supporting the conservation of 24,654 proteins and 3,849 single-copy gene clusters. Candida haemulonii var. vulnera shared a larger number of clusters with C. haemulonii and C. auris; however, more singletons were identified in C. lusitaniae and C. auris. Additionally, a multiple sequence alignment of Erg11p proteins revealed variants likely involved in reduced susceptibility to azole and polyene antifungal agents. The data presented in this work will, therefore, be of utmost importance for researchers studying the biology of the C. haemulonii complex and related species.
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Affiliation(s)
- Luiza Souza Rodrigues
- Faculdades Pequeno Príncipe, Curitiba, Brazil.,Instituto de Pesquisas Pelé Pequeno Príncipe, Curitiba, Brazil
| | - Rajesh Kumar Gazara
- Laboratório de Química e Função de Proteínas e Peptídeos, Centro de Biociências e Biotecnologia, Universidade Estadual do Norte Fluminense Darcy Ribeiro, Campos dos Goytacazes, Brazil.,Department of Biotechnology, Indian Institute of Technology Roorkee, Roorkee, India.,Department of Electrical Engineering, Indian Institute of Technology Roorkee, Roorkee, India
| | - Hemanoel Passarelli-Araujo
- Laboratório de Química e Função de Proteínas e Peptídeos, Centro de Biociências e Biotecnologia, Universidade Estadual do Norte Fluminense Darcy Ribeiro, Campos dos Goytacazes, Brazil.,Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Paula Veronesi Marinho Pontes
- Instituto de Biodiversidade e Sustentabilidade, Núcleo em Ecologia e Desenvolvimento Sócio-Ambiental de Macaé, Universidade Federal do Rio de Janeiro, Macaé, Brazil
| | - Rodrigo Nunes-da-Fonseca
- Instituto de Biodiversidade e Sustentabilidade, Núcleo em Ecologia e Desenvolvimento Sócio-Ambiental de Macaé, Universidade Federal do Rio de Janeiro, Macaé, Brazil
| | - Robson Francisco de Souza
- Laboratório de Estrutura e Evolução de Proteínas, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Thiago Motta Venancio
- Laboratório de Química e Função de Proteínas e Peptídeos, Centro de Biociências e Biotecnologia, Universidade Estadual do Norte Fluminense Darcy Ribeiro, Campos dos Goytacazes, Brazil
| | - Libera Maria Dalla-Costa
- Faculdades Pequeno Príncipe, Curitiba, Brazil.,Instituto de Pesquisas Pelé Pequeno Príncipe, Curitiba, Brazil
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29
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Xie O, Streitberg R, Hughes C, Stuart R, Graham M. Candida duobushaemulonii sepsis and Candida auris co-isolation following hospitalisation in Vietnam. Pathology 2020; 52:590-591. [PMID: 32600658 DOI: 10.1016/j.pathol.2020.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 05/02/2020] [Accepted: 05/18/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Ouli Xie
- Microbiology Department, Monash Health, Clayton, Vic, Australia; Department of Infectious Diseases, Monash Health, Clayton, Vic, Australia.
| | | | - Carly Hughes
- Microbiology Department, Monash Health, Clayton, Vic, Australia; Department of Infectious Diseases, Monash Health, Clayton, Vic, Australia
| | - Rhonda Stuart
- Department of Infectious Diseases, Monash Health, Clayton, Vic, Australia
| | - Maryza Graham
- Microbiology Department, Monash Health, Clayton, Vic, Australia; Department of Infectious Diseases, Monash Health, Clayton, Vic, Australia; Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, Vic, Australia
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30
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Gade L, Muñoz JF, Sheth M, Wagner D, Berkow EL, Forsberg K, Jackson BR, Ramos-Castro R, Escandón P, Dolande M, Ben-Ami R, Espinosa-Bode A, Caceres DH, Lockhart SR, Cuomo CA, Litvintseva AP. Understanding the Emergence of Multidrug-Resistant Candida: Using Whole-Genome Sequencing to Describe the Population Structure of Candida haemulonii Species Complex. Front Genet 2020; 11:554. [PMID: 32587603 PMCID: PMC7298116 DOI: 10.3389/fgene.2020.00554] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 05/07/2020] [Indexed: 11/16/2022] Open
Abstract
The recent emergence of a multidrug-resistant yeast, Candida auris, has drawn attention to the closely related species from the Candida haemulonii complex that include C. haemulonii, Candida duobushaemulonii, Candida pseudohaemulonii, and the recently identified Candida vulturna. Here, we used antifungal susceptibility testing and whole-genome sequencing (WGS) to investigate drug resistance and genetic diversity among isolates of C. haemulonii complex from different geographic areas in order to assess population structure and the extent of clonality among strains. Although most isolates of all four species were genetically distinct, we detected evidence of the in-hospital transmission of C. haemulonii and C. duobushaemulonii in one hospital in Panama, indicating that these species are also capable of causing outbreaks in healthcare settings. We also detected evidence of the rising azole resistance among isolates of C. haemulonii and C. duobushaemulonii in Colombia, Panama, and Venezuela linked to substitutions in ERG11 gene as well as amplification of this gene in C. haemulonii in isolates in Colombia suggesting the presence of evolutionary pressure for developing azole resistance in this region. Our results demonstrate that these species need to be monitored as possible causes of outbreaks of invasive infection.
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Affiliation(s)
- Lalitha Gade
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jose F Muñoz
- Infectious Disease and Microbiome Program, Broad Institute, Cambridge, MA, United States
| | - Mili Sheth
- Biotechnology Core Facility Branch, DSR/NCEZID - Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Darlene Wagner
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States.,IHRC, Inc., Atlanta, GA, United States
| | - Elizabeth L Berkow
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Kaitlin Forsberg
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Brendan R Jackson
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Ruben Ramos-Castro
- Department of Clinical and Molecular Microbiology, Instituto Conmemorativo Gorgas de Estudios de La Salud, Panama City, Panama
| | - Patricia Escandón
- Grupo de Microbiologia, Instituto Nacional de Salud, Bogotá, Colombia
| | - Maribel Dolande
- Departamento de Micología, Instituto Nacional de Higiene Rafael Rangel, Caracas, Venezuela
| | - Ronen Ben-Ami
- Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Andrés Espinosa-Bode
- DGHP (Division of Global Health Protection), Central America Region Office, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Diego H Caceres
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States.,Center of Expertise in Mycology Radboudumc/CWZ, Nijmegen, Netherlands
| | - Shawn R Lockhart
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Christina A Cuomo
- Infectious Disease and Microbiome Program, Broad Institute, Cambridge, MA, United States
| | - Anastasia P Litvintseva
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States
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31
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Biofilm Formed by Candida haemulonii Species Complex: Structural Analysis and Extracellular Matrix Composition. J Fungi (Basel) 2020; 6:jof6020046. [PMID: 32260180 PMCID: PMC7345111 DOI: 10.3390/jof6020046] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 04/01/2020] [Accepted: 04/01/2020] [Indexed: 01/18/2023] Open
Abstract
Candida haemulonii species complex (C. haemulonii, C. duobushaemulonii, and C. haemulonii var. vulnera) has emerged as opportunistic, multidrug-resistant yeasts able to cause fungemia. Previously, we showed that C. haemulonii complex formed biofilm on polystyrene. Biofilm is a well-known virulence attribute of Candida spp. directly associated with drug resistance. In the present study, the architecture and the main extracellular matrix (ECM) components forming the biofilm over polystyrene were investigated in clinical isolates of the C. haemulonii complex. We also evaluated the ability of these fungi to form biofilm on catheters used in medical arena. The results revealed that all fungi formed biofilms on polystyrene after 48 h at 37 °C. Microscopic analyses demonstrated a dense network of yeasts forming the biofilm structure, with water channels and ECM. Regarding ECM, proteins and carbohydrates were the main components, followed by nucleic acids and sterols. Mature biofilms were also detected on late bladder (siliconized latex), nasoenteric (polyurethane), and nasogastric (polyvinyl chloride) catheters, with the biomasses being significantly greater than on polystyrene. Collectively, our results demonstrated the ability of the C. haemulonii species complex to form biofilm on different types of inert surfaces, which is an incontestable virulence attribute associated with devices-related candidemia in hospitalized individuals.
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Silva LN, de Mello TP, de Souza Ramos L, Branquinha MH, Dos Santos ALS. New and Promising Chemotherapeutics for Emerging Infections Involving Drug-resistant Non-albicans Candida Species. Curr Top Med Chem 2020; 19:2527-2553. [PMID: 31654512 DOI: 10.2174/1568026619666191025152412] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 02/13/2019] [Accepted: 02/16/2019] [Indexed: 02/06/2023]
Abstract
Fungal infections are a veritable public health problem worldwide. The increasing number of patient populations at risk (e.g. transplanted individuals, cancer patients, and HIV-infected people), as well as the use of antifungal agents for prophylaxis in medicine, have favored the emergence of previously rare or newly identified fungal species. Indeed, novel antifungal resistance patterns have been observed, including environmental sources and the emergence of simultaneous resistance to different antifungal classes, especially in Candida spp., which are known for the multidrug-resistance (MDR) profile. In order to circumvent this alarming scenario, the international researchers' community is engaged in discovering new, potent, and promising compounds to be used in a near future to treat resistant fungal infections in hospital settings on a global scale. In this context, many compounds with antifungal action from both natural and synthetic sources are currently under clinical development, including those that target either ergosterol or β(1,3)-D-glucan, presenting clear evidence of pharmacologic/pharmacokinetic advantages over currently available drugs against these two well-known fungal target structures. Among these are the tetrazoles VT-1129, VT-1161, and VT-1598, the echinocandin CD101, and the glucan synthase inhibitor SCY-078. In this review, we compiled the most recent antifungal compounds that are currently in clinical trials of development and described the potential outcomes against emerging and rare Candida species, with a focus on C. auris, C. dubliniensis, C. glabrata, C. guilliermondii, C. haemulonii, and C. rugosa. In addition to possibly overcoming the limitations of currently available antifungals, new investigational chemical agents that can enhance the classic antifungal activity, thereby reversing previously resistant phenotypes, were also highlighted. While novel and increasingly MDR non-albicans Candida species continue to emerge worldwide, novel strategies for rapid identification and treatment are needed to combat these life-threatening opportunistic fungal infections.
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Affiliation(s)
- Laura Nunes Silva
- Laboratorio de Estudos Avancados de Microrganismos Emergentes e Resistentes, Departamento de Microbiologia Geral, Instituto de Microbiologia Paulo de Goes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Thaís Pereira de Mello
- Laboratorio de Estudos Avancados de Microrganismos Emergentes e Resistentes, Departamento de Microbiologia Geral, Instituto de Microbiologia Paulo de Goes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lívia de Souza Ramos
- Laboratorio de Estudos Avancados de Microrganismos Emergentes e Resistentes, Departamento de Microbiologia Geral, Instituto de Microbiologia Paulo de Goes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marta Helena Branquinha
- Laboratorio de Estudos Avancados de Microrganismos Emergentes e Resistentes, Departamento de Microbiologia Geral, Instituto de Microbiologia Paulo de Goes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - André Luis Souza Dos Santos
- Laboratorio de Estudos Avancados de Microrganismos Emergentes e Resistentes, Departamento de Microbiologia Geral, Instituto de Microbiologia Paulo de Goes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.,Programa de Pós-Graduação em Bioquímica, Instituto de Química, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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33
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Global Screening of Genomic and Transcriptomic Factors Associated with Phenotype Differences between Multidrug-Resistant and -Susceptible Candida haemulonii Strains. mSystems 2019; 4:4/6/e00459-19. [PMID: 31848301 PMCID: PMC6918027 DOI: 10.1128/msystems.00459-19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
A comprehensive, multi-omic survey was performed to disclose the genetic backgrounds and differences between multidrug-resistant and -susceptible C. haemulonii strains. Genes were identified with mutations or significant expression differences in multidrug-resistant compared to multidrug-susceptible strains, which were mainly involved in multidrug resistance, stress fitness, and morphology. The Cdr1-encoding gene, C. haemulonii2486 (CH_2486), was expressed at a significantly increased level in multidrug-resistant strains. Functional inhibition experiments further implicated potential roles of CH_2486 in drug resistance. A gene spontaneously mutated in resistant strains, CH_4347, was experimentally validated to influence the morphology of spores, possibly by controlling cell wall integrity. Candida haemulonii, a close relative of Candida auris, is an emerging pathogen which frequently shows multidrug resistance especially to triazoles, the most used antifungal drugs. The mechanisms of drug resistance in C. haemulonii, however, are largely unknown. Here, we sequenced and annotated the genomes of two reference strains from the C. haemulonii complex, compared the phenotypes, genomes, and transcriptomes of a triazole-susceptible and two triazole-resistant C. haemulonii strains, and identified triazole susceptibility, morphology, fitness, and the major genetic and gene expression differences between the strains. A multidrug efflux gene, CDR1, was recurrently found to be upregulated for expression in triazole-resistant strains. Blocking the activity of Cdr1 increased the susceptibility to triazoles strikingly. Comparative transcriptome analysis also demonstrated impaired cell wall integrity, filamentous growth, and iron homeostasis in triazole-resistant strains. Finally, we also identified a zinc-binding MHR family transcription regulator gene that mutated in triazole-resistant strains spontaneously, contributing to the changes of morphology and, possibly, cell wall integrity between the strains. The study provided important clues for future studies exploring the mechanisms of multidrug resistance and related phenotypic differences of C. haemulonii strains. IMPORTANCE A comprehensive, multi-omic survey was performed to disclose the genetic backgrounds and differences between multidrug-resistant and -susceptible C. haemulonii strains. Genes were identified with mutations or significant expression differences in multidrug-resistant compared to multidrug-susceptible strains, which were mainly involved in multidrug resistance, stress fitness, and morphology. The Cdr1-encoding gene, C. haemulonii2486 (CH_2486), was expressed at a significantly increased level in multidrug-resistant strains. Functional inhibition experiments further implicated potential roles of CH_2486 in drug resistance. A gene spontaneously mutated in resistant strains, CH_4347, was experimentally validated to influence the morphology of spores, possibly by controlling cell wall integrity.
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Xu H, Yu SY, Zhou ML, Ning YT, Xiao M, Li XG, Chen M, Kong F, Chen S, Ming L, Xu YC. Epidemiology And Antifungal Susceptibility Patterns Of Invasive Fungal Infections From 2012 To 2014 In A Teaching Hospital In Central China. Infect Drug Resist 2019; 12:3641-3651. [PMID: 31819547 PMCID: PMC6878932 DOI: 10.2147/idr.s227839] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 11/08/2019] [Indexed: 12/11/2022] Open
Abstract
Introduction As participants of the national China Hospital Invasive Fungal Surveillance Net program, we sought to describe the epidemiology and antifungal susceptibility patterns of yeast isolates obtained from patients with invasive fungal infection at the First Affiliated Hospital of Zhengzhou University, China. Methods A total of 434 yeast isolates recovered from blood and other sterile body fluids were identified to species by matrix-assisted laser desorption ionization –time of flight mass spectrometry with or without supplementation by DNA sequencing. Antifungal susceptibilities were determined by Sensititre YeastOneTM YO10 methodology. Results Candida albicans was the most common causative species (33.9% of isolates) but significantly decreased in frequency from 37.2% to 27.7% from 2012 to 2014. C. tropicalis was the next most common pathogen (25.1%), followed by C. parapsilosis complex (17.3%), C. glabrata (9%), and C. pelliculosa (6.7%), with other species comprising 8% of isolates. Caspofungin, micafungin, and anidulafungin exhibited potent in vitro activities against the majority of Candida isolates. Azoles demonstrated in vitro activities against C. albicans with a susceptibility rate of >95% and against C. parapsilosis complex, >95% isolates were susceptible. Among C. tropicalis and C. glabrata isolates, resistance rates to fluconazole and voriconazole were 11.9%, 9.1% and 7.7%, 28.2%, respectively. Of note, C. pelliculosa had a high incidence rate in newborns and high rates of resistance to fluconazole and voriconazole of 55.2% and 41.4%, respectively. Conclusion The present study provided valuable local surveillance data on the epidemiology and antifungal susceptibilities of invasive yeast species, which is essential for guiding antifungal treatment protocol development.
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Affiliation(s)
- Hui Xu
- Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University and Key Laboratory of Clinical Laboratory of Henan Province, Henan 450003, People's Republic of China
| | - Shu-Ying Yu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, People's Republic of China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, People's Republic of China.,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases (BZ0447), Beijing, People's Republic of China
| | - Meng-Lan Zhou
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, People's Republic of China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, People's Republic of China.,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases (BZ0447), Beijing, People's Republic of China
| | - Ya-Ting Ning
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, People's Republic of China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, People's Republic of China.,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases (BZ0447), Beijing, People's Republic of China
| | - Meng Xiao
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, People's Republic of China.,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases (BZ0447), Beijing, People's Republic of China
| | - Xiao-Gai Li
- Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University and Key Laboratory of Clinical Laboratory of Henan Province, Henan 450003, People's Republic of China
| | - Meng Chen
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, People's Republic of China.,Department of Clinical Laboratory, Beijing Pinggu Hospital of Traditional Chinese Medicine, Beijing 101200, People's Republic of China
| | - Fanrong Kong
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR - New South Wales Health Pathology, The University of Sydney, Westmead Hospital, Westmead, NSW, Australia
| | - Sharon Chen
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR - New South Wales Health Pathology, The University of Sydney, Westmead Hospital, Westmead, NSW, Australia
| | - Liang Ming
- Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University and Key Laboratory of Clinical Laboratory of Henan Province, Henan 450003, People's Republic of China
| | - Ying-Chun Xu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, People's Republic of China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, People's Republic of China
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Frías-De-León MG, Martínez-Herrera E, Acosta-Altamirano G, Arenas R, Rodríguez-Cerdeira C. Superficial candidosis by Candida duobushaemulonii: An emerging microorganism. INFECTION GENETICS AND EVOLUTION 2019; 75:103960. [DOI: 10.1016/j.meegid.2019.103960] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 07/05/2019] [Accepted: 07/09/2019] [Indexed: 10/26/2022]
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Jackson BR, Chow N, Forsberg K, Litvintseva AP, Lockhart SR, Welsh R, Vallabhaneni S, Chiller T. On the Origins of a Species: What Might Explain the Rise of Candida auris? J Fungi (Basel) 2019; 5:E58. [PMID: 31284576 PMCID: PMC6787658 DOI: 10.3390/jof5030058] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 06/28/2019] [Accepted: 07/01/2019] [Indexed: 11/16/2022] Open
Abstract
Candida auris is an emerging multidrug-resistant yeast first described in 2009 that has since caused healthcare-associated outbreaks of severe human infections around the world. In some hospitals, it has become a leading cause of invasive candidiasis. C. auris is markedly different from most other pathogenic Candida species in its genetics, antifungal resistance, and ability to spread between patients. The reasons why this fungus began spreading widely in the last decade remain a mystery. We examine available data on C. auris and related species, including genomic epidemiology, phenotypic characteristics, and sites of detection, to put forth hypotheses on its possible origins. C. auris has not been detected in the natural environment; related species have been detected in in plants, insects, and aquatic environments, as well as from human body sites. It can tolerate hypersaline environments and higher temperatures than most Candida species. We explore hypotheses about the pre-emergence niche of C. auris, whether in the environmental or human microbiome, and speculate on factors that might have led to its spread, including the possible roles of healthcare, antifungal use, and environmental changes, including human activities that might have expanded its presence in the environment or caused increased human contact.
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Affiliation(s)
- Brendan R Jackson
- Centers for Disease Control and Prevention, Division of Foodborne, Waterborne, and Environmental Diseases, Mycotic Diseases Branch, Atlanta, GA 30329, USA.
| | - Nancy Chow
- Centers for Disease Control and Prevention, Division of Foodborne, Waterborne, and Environmental Diseases, Mycotic Diseases Branch, Atlanta, GA 30329, USA
| | - Kaitlin Forsberg
- Centers for Disease Control and Prevention, Division of Foodborne, Waterborne, and Environmental Diseases, Mycotic Diseases Branch, Atlanta, GA 30329, USA
- IHRC, Inc., Atlanta, GA 30346, USA
| | - Anastasia P Litvintseva
- Centers for Disease Control and Prevention, Division of Foodborne, Waterborne, and Environmental Diseases, Mycotic Diseases Branch, Atlanta, GA 30329, USA
| | - Shawn R Lockhart
- Centers for Disease Control and Prevention, Division of Foodborne, Waterborne, and Environmental Diseases, Mycotic Diseases Branch, Atlanta, GA 30329, USA
| | - Rory Welsh
- Centers for Disease Control and Prevention, Division of Foodborne, Waterborne, and Environmental Diseases, Mycotic Diseases Branch, Atlanta, GA 30329, USA
| | - Snigdha Vallabhaneni
- Centers for Disease Control and Prevention, Division of Healthcare Quality Promotion, Prevention and Response Branch, Atlanta, GA 30329, USA
| | - Tom Chiller
- Centers for Disease Control and Prevention, Division of Foodborne, Waterborne, and Environmental Diseases, Mycotic Diseases Branch, Atlanta, GA 30329, USA
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Stavrou AA, Lackner M, Lass-Flörl C, Boekhout T. The changing spectrum of Saccharomycotina yeasts causing candidemia: phylogeny mirrors antifungal susceptibility patterns for azole drugs and amphothericin B. FEMS Yeast Res 2019; 19:5510445. [DOI: 10.1093/femsyr/foz037] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 05/20/2019] [Indexed: 12/14/2022] Open
Affiliation(s)
- Aimilia A Stavrou
- Yeast Research, Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT, Utrecht, The Netherlands
- Institute for Biodiversity and Ecosystem Dynamics (IBED), University of Amsterdam, Sciencepark 904, 1098XH Amsterdam, The Netherlands
| | - Michaela Lackner
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Schöpfstrasse 41, 6020 Innsbruck, Austria
| | - Cornelia Lass-Flörl
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Schöpfstrasse 41, 6020 Innsbruck, Austria
| | - Teun Boekhout
- Yeast Research, Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT, Utrecht, The Netherlands
- Institute for Biodiversity and Ecosystem Dynamics (IBED), University of Amsterdam, Sciencepark 904, 1098XH Amsterdam, The Netherlands
- Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
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Arastehfar A, Fang W, Daneshnia F, Al-Hatmi AM, Liao W, Pan W, Khan Z, Ahmad S, Rosam K, Lackner M, Lass-Flörl C, Hagen F, Boekhout T. Novel multiplex real-time quantitative PCR detecting system approach for direct detection of Candida auris and its relatives in spiked serum samples. Future Microbiol 2018; 14:33-45. [PMID: 30539665 DOI: 10.2217/fmb-2018-0227] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The multidrug-resistant opportunistic yeast species of Candida auris, Candida haemulonii, Candida duobushaemulonii and Candida pseudohaemulonii continue to endanger the healthcare settings around the globe. Due to the lack of a specific qPCR assay for detection of these species from clinical samples, we developed a multiplex qPCR assay. Analytical specificity and sensitivity showed 100% specificity and the sensitivity of up to ten genomes of target species with a high value of reproducibility (R2 >0.99). Subsequently, from spiked serum samples, our qPCR specifically could detect up to ten genomes of C. auris and one genome of C. haemulonii, C. duobushaemulonii and C. pseudohaemulonii (R2 >0.98). Lack of cross reaction with the human DNA, a high degree of specificity and sensitivity, showed the potential of our multiplex PCR for direct detection of C. auris and closely related species from serum samples of suspected patients. Future studies are warranted to assure its applicability in clinical settings.
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Affiliation(s)
- Amir Arastehfar
- Westerdijk Fungal Biodiversity Institute, Utrecht 3584, The Netherlands
| | - Wenjie Fang
- Westerdijk Fungal Biodiversity Institute, Utrecht 3584, The Netherlands.,Department of Dermatology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China
| | - Farnaz Daneshnia
- Westerdijk Fungal Biodiversity Institute, Utrecht 3584, The Netherlands
| | - Abdullah Ms Al-Hatmi
- Westerdijk Fungal Biodiversity Institute, Utrecht 3584, The Netherlands.,Center of Expertise in Mycology Radboud University Medical Center, Canisius Wilhelmina Hospital, Nijmegen 6500HB, The Netherlands.,Ministry of Health, Directorate General of Health Services, PO Box 393, 100 Muscat, Oman
| | - Wanqing Liao
- Department of Dermatology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China
| | - Weihua Pan
- Department of Dermatology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China
| | - Ziauddin Khan
- Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Suhail Ahmad
- Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Katharina Rosam
- Division of Hygiene & Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Michaela Lackner
- Division of Hygiene & Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Cornelia Lass-Flörl
- Division of Hygiene & Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ferry Hagen
- Westerdijk Fungal Biodiversity Institute, Utrecht 3584, The Netherlands
| | - Teun Boekhout
- Westerdijk Fungal Biodiversity Institute, Utrecht 3584, The Netherlands.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China.,Institute of Biodiversity & Ecosystem Dynamics, University of Amsterdam, Amsterdam 1012 WX, The Netherlands
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Five-Year National Surveillance of Invasive Candidiasis: Species Distribution and Azole Susceptibility from the China Hospital Invasive Fungal Surveillance Net (CHIF-NET) Study. J Clin Microbiol 2018; 56:JCM.00577-18. [PMID: 29743305 DOI: 10.1128/jcm.00577-18] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 05/03/2018] [Indexed: 02/05/2023] Open
Abstract
Data on the epidemiology of invasive candidiasis (IC) and the antifungal susceptibility of Candida isolates in China are still limited. Here we report on surveillance for IC from the China Hospital Invasive Fungal Surveillance Net (CHIF-NET) study. Sixty-five tertiary hospitals collected 8,829 Candida isolates from 1 August 2009 to 31 July 2014. Matrix-assisted laser desorption ionization-time of flight mass spectrometry supplemented by ribosomal DNA sequencing was used to define the species, and the fluconazole and voriconazole susceptibilities were determined by the Clinical and Laboratory Standards Institute disk diffusion method. A total of 32 Candida species were identified. Candida albicans was the most common species (44.9%), followed by the C. parapsilosis complex (20.0%), C. tropicalis (17.2%), and the C. glabrata complex (10.8%), with other species comprising <3% of isolates. However, in candidemia, the proportion of cases caused by C. albicans was only 32.3%. C. albicans and C. parapsilosis complex isolates were susceptible to fluconazole and voriconazole (<6% resistance), while fluconazole and azole cross-resistance rates were high in C. tropicalis (13.3% and 12.9%, respectively), C. glabrata complex (18.7% and 14%, respectively), and uncommon Candida species (44.1% and 10.3%, respectively) isolates. Moreover, from years 1 to 5 of the study, there was a significant increase in the rates of resistance to fluconazole among C. glabrata complex isolates (12.2% to 24.0%) and to both fluconazole (5.7% to 21.0%) and voriconazole (5.7% to 21.4%) among C. tropicalis isolates (P < 0.01 for all comparisons). Geographic variations in the causative species and susceptibilities were noted. Our findings indicate that antifungal resistance has become noteworthy in China, and enhanced surveillance is warranted.
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Emerging Multidrug-Resistant Candida duobushaemulonii Infections in Panama Hospitals: Importance of Laboratory Surveillance and Accurate Identification. J Clin Microbiol 2018; 56:JCM.00371-18. [PMID: 29695521 DOI: 10.1128/jcm.00371-18] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 04/17/2018] [Indexed: 01/27/2023] Open
Abstract
Candida duobushaemulonii, a yeast closely related to Candida auris, is thought to cause infections in rare cases and is often misidentified. In October 2016, the Panamanian Ministry of Health implemented laboratory surveillance for C. auris Suspected C. auris isolates were forwarded to the national reference laboratory for identification by matrix-assisted laser desorption ionization-time of flight mass spectrometry and antifungal susceptibility testing. Between November 2016 and May 2017, 17 of 36 (47%) isolates suspected to be C. auris were identified as C. duobushaemulonii. These 17 isolates were obtained from 14 patients at six hospitals. Ten patients, including three children, had bloodstream infections, and MICs for fluconazole, voriconazole, and amphotericin B were elevated. No resistance to echinocandins was observed. C. duobushaemulonii causes more invasive infections than previously appreciated and poses a substantial problem, given its resistance to multiple antifungals. Expanded laboratory surveillance is an important step in the detection and control of such emerging pathogens.
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Arastehfar A, Fang W, Badali H, Vaezi A, Jiang W, Liao W, Pan W, Hagen F, Boekhout T. Low-Cost Tetraplex PCR for the Global Spreading Multi-Drug Resistant Fungus, Candida auris and Its Phylogenetic Relatives. Front Microbiol 2018; 9:1119. [PMID: 29896181 PMCID: PMC5987591 DOI: 10.3389/fmicb.2018.01119] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 05/11/2018] [Indexed: 12/20/2022] Open
Abstract
Candida auris, C. haemulonii, C. duobushaemulonii, and C. pseudohaemulonii are closely related and highly multidrug resistant yeast pathogens. The high cost and low accuracy of current diagnostics may underestimate their prevalence, especially in medical resource-limited regions. In this study, we used 172 C. auris stains and its relatives and 192 other fungal strains to establish and validate a novel multiplex end-point PCR. A prospective and a retrospective clinical screenings using this assay were further performed in China and Iran respectively. We identified the first isolate of C. pseudohaemulonii in China and the first isolate of C. haemulonii in Iran from 821 clinical isolates in total, without any false positive. Animal models of C. auris and C. haemulonii were established for validation. The overall positive rates of the assay for mice blood and tissue were 28.6 and 92.9%, respectively. Compared with previously developed assays, our assay is more available and affordable to the developing countries, and may contribute to a better understanding of the epidemiology of C. auris and its relatives in these regions.
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Affiliation(s)
- Amir Arastehfar
- Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands
| | - Wenjie Fang
- Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands.,Department of Dermatology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Hamid Badali
- Department of Medical Mycology/Invasive Fungi Research Center, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Afsane Vaezi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Weiwei Jiang
- Department of Dermatology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Wanqing Liao
- Department of Dermatology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Weihua Pan
- Department of Dermatology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Ferry Hagen
- Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands
| | - Teun Boekhout
- Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.,Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, Netherlands
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Abstract
PURPOSE OF REVIEW To describe the epidemiology, strategies for early detection, and clinical management of infections caused by the most commonly found multidrug-resistant (MDR) Candida spp. RECENT FINDINGS Increasing numbers of reports describing invasive infections by MDR Candida auris and Candida glabrata has been reported in medical centers worldwide. SUMMARY We checked all papers published along the last 10 years describing epidemiological, diagnostic, and clinical aspects of infections by MDR Candida spp., with emphasis on C. auris and C. glabrata spp. C. auris has been reported in 15 countries and multidrug resistance rates is usually above 30%. Horizontal transmission is a great concern regarding C. auris. C. glabrata ranks the second most reported Candida spp. in deep-seated infections from United States and some European Centers, although multidrug resistance rates above 10% are restricted to some US centers. Candida haemulonii complex isolates with poor susceptibility to azoles and amphotericin B have been isolated in superficial and deep-seated infections, whereas Candida guilliiermondii complex isolates with poor susceptibility to azoles and echinocandins have been recovered from catheter-related bloodstream infections. Other potential MDR Candida species are Candida krusei, Candida lusitaniae, Candida kefyr, Yarrowia (Candida) lypolitica, and Candida rugosa.
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Hou X, Xiao M, Chen SC, Kong F, Wang H, Fan X, Zhao YP, Xu YC. Identification of Candida glabrata complex species: use of Vitek MS ® RUO & Bruker ClinproTools ®. Future Microbiol 2018; 13:645-657. [PMID: 29745727 DOI: 10.2217/fmb-2017-0241] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
AIM Distinction of species within the Candida glabrata complex (i.e., C. glabrata sensu stricto, Candida nivariensis and Candida bracarensis) is relevant for epidemiological purposes and antifungal management. MATERIALS & METHODS Two commercial matrix-assisted laser desorption ionization-time of flight mass spectrometry systems were comprehensively evaluated for the identification of fungi within this complex. RESULTS None of the species (C. nivariensis and C. bracarensis) were identified correctly by Vitek mass spectrometry (MS®) v2.0 In Vitro Diagnosis system and Bruker Biotyper MS® v3.1, but all were correct by the Vitek MS® Research Use Only system. The Bruker ClinProTools software showed 100% recognition capability and cross validation for the discrimination of C. nivariensis and C. bracarensis. CONCLUSION Using Vitek MS Research Use Only and Bruker ClinProTools can overcome limitations of the Vitek MS In Vitro Diagnosis and Bruker Biotyper databases in the identification of C. glabrata complex.
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Affiliation(s)
- Xin Hou
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, PR China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, PR China.,Beijing Key Laboratory for Mechanisms Research & Precision Diagnosis of Invasive Fungal Diseases (BZ0447), Beijing, PR China
| | - Meng Xiao
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, PR China.,Beijing Key Laboratory for Mechanisms Research & Precision Diagnosis of Invasive Fungal Diseases (BZ0447), Beijing, PR China
| | - Sharon Ca Chen
- Centre for Infectious Diseases & Microbiology Laboratory Services, ICPMR - Pathology West, Westmead Hospital, University of Sydney, Darcy Road, Westmead, New South Wales, Australia
| | - Fanrong Kong
- Centre for Infectious Diseases & Microbiology Laboratory Services, ICPMR - Pathology West, Westmead Hospital, University of Sydney, Darcy Road, Westmead, New South Wales, Australia
| | - He Wang
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, PR China.,Beijing Key Laboratory for Mechanisms Research & Precision Diagnosis of Invasive Fungal Diseases (BZ0447), Beijing, PR China
| | - Xin Fan
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, PR China.,Beijing Key Laboratory for Mechanisms Research & Precision Diagnosis of Invasive Fungal Diseases (BZ0447), Beijing, PR China
| | - Yu-Pei Zhao
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, PR China
| | - Ying-Chun Xu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, PR China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, PR China.,Beijing Key Laboratory for Mechanisms Research & Precision Diagnosis of Invasive Fungal Diseases (BZ0447), Beijing, PR China
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Genome Sequence of the Amphotericin B-Resistant Candida duobushaemulonii Strain B09383. GENOME ANNOUNCEMENTS 2018; 6:6/13/e00204-18. [PMID: 29599161 PMCID: PMC5876483 DOI: 10.1128/genomea.00204-18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Candida duobushaemulonii is a drug-resistant yeast that can cause invasive candidiasis. Here, we report the first genome sequence of C. duobushaemulonii, isolate B09383, generated using PacBio sequencing technology. The estimated genome size was 12.5 Mb with a GC content of 46.84%.
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Vieira CD, Tagliaferri TL, de Carvalho MAR, de Resende-Stoianoff MA, Holanda RA, de Magalhães TFF, Magalhães PP, Dos Santos SG, de Macêdo Farias L. Investigating cross-contamination by yeast strains from dental solid waste to waste-handling workers by DNA sequencing. Microbiologyopen 2017; 7:e00554. [PMID: 29277980 PMCID: PMC5911987 DOI: 10.1002/mbo3.554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 09/15/2017] [Accepted: 09/26/2017] [Indexed: 12/11/2022] Open
Abstract
Trying to widen the discussion on the risks associated with dental waste, this study proposed to investigate and genetically compare yeast isolates recovered from dental solid waste and waste workers. Three samples were collected from workers' hands, nasal mucosa, and professional clothing (days 0, 30, and 180), and two from dental waste (days 0 and 180). Slide culture, microscopy, antifungal drug susceptibility, intersimple sequence repeat analysis, and amplification and sequencing of internal transcribed spacer regions were performed. Yeast strains were recovered from all waste workers' sites, including professional clothes, and from waste. Antifungal susceptibility testing demonstrated that some yeast recovered from employees and waste exhibited nonsusceptible profiles. The dendrogram demonstrated the presence of three major clusters based on similarity matrix and UPGMA grouping method. Two branches displayed 100% similarity: three strains of Candida guilliermondii isolated from different employees, working in opposite work shifts, and from diverse sites grouped in one part of branch 1 and cluster 3 that included two samples of Candida albicans recovered from waste and the hand of one waste worker. The results suggested the possibility of cross‐contamination from dental waste to waste workers and reinforce the need of training programs focused on better waste management routines.
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Affiliation(s)
- Cristina Dutra Vieira
- Laboratory of Oral Microbiology and Anaerobes, Department of Microbiology, Institute of Biological Sciences, Federal University of Minas Gerais - Avenida Antônio Carlos, Belo Horizonte, Brazil
| | - Thaysa Leite Tagliaferri
- Laboratory of Oral Microbiology and Anaerobes, Department of Microbiology, Institute of Biological Sciences, Federal University of Minas Gerais - Avenida Antônio Carlos, Belo Horizonte, Brazil
| | - Maria Auxiliadora Roque de Carvalho
- Laboratory of Oral Microbiology and Anaerobes, Department of Microbiology, Institute of Biological Sciences, Federal University of Minas Gerais - Avenida Antônio Carlos, Belo Horizonte, Brazil
| | - Maria Aparecida de Resende-Stoianoff
- Mycology Laboratory, Department of Microbiology, Institute of Biological Sciences, Federal University of Minas Gerais - Avenida Antônio Carlos, Belo Horizonte, Brazil
| | - Rodrigo Assuncao Holanda
- Mycology Laboratory, Department of Microbiology, Institute of Biological Sciences, Federal University of Minas Gerais - Avenida Antônio Carlos, Belo Horizonte, Brazil.,Parasite Biology Laboratory, CEUMA University - Rua dos Castanheiros, São Luís, Brazil
| | - Thais Furtado Ferreira de Magalhães
- Mycology Laboratory, Department of Microbiology, Institute of Biological Sciences, Federal University of Minas Gerais - Avenida Antônio Carlos, Belo Horizonte, Brazil
| | - Paula Prazeres Magalhães
- Laboratory of Oral Microbiology and Anaerobes, Department of Microbiology, Institute of Biological Sciences, Federal University of Minas Gerais - Avenida Antônio Carlos, Belo Horizonte, Brazil
| | - Simone Gonçalves Dos Santos
- Laboratory of Oral Microbiology and Anaerobes, Department of Microbiology, Institute of Biological Sciences, Federal University of Minas Gerais - Avenida Antônio Carlos, Belo Horizonte, Brazil
| | - Luiz de Macêdo Farias
- Laboratory of Oral Microbiology and Anaerobes, Department of Microbiology, Institute of Biological Sciences, Federal University of Minas Gerais - Avenida Antônio Carlos, Belo Horizonte, Brazil
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Isla G, Taverna CG, Szusz W, Vivot W, García-Effron G, Davel G. Candida haemulonii sensu lato: Update of the Determination of Susceptibility Profile in Argentina and Literature Review. CURRENT FUNGAL INFECTION REPORTS 2017. [DOI: 10.1007/s12281-017-0300-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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